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LaRose JG, Gorin AA, Garcia K, Hayes JF, Tate DF, Espeland MA, Lewis CE, Perdue L, Robichaud E, Hatley K, Wing RR. Life events and stress among young adults in weight gain prevention trial. Health Psychol 2023; 42:314-324. [PMID: 37141017 PMCID: PMC10167549 DOI: 10.1037/hea0001282] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/05/2023]
Abstract
OBJECTIVE Young adults (YAs) are at high risk for weight gain and show high variability in treatment response. Life events and high perceived stress are common in YAs and could drive less favorable outcomes. The goal was to examine whether life events and stress were related to program engagement and weight outcomes in a weight gain prevention trial for YAs. METHOD Secondary analysis from the Study of Novel Approaches to Weight Gain Prevention (SNAP), a randomized clinical trial (N = 599, 18-35 years, BMI 21-30 kg/m²). Both intervention arms received 10 in-person sessions over 4 months, with long-term contact via web and SMS. Participants completed the CARDIA life events survey and Cohen Perceived Stress Scale-4 at 0 and 4 months; weight was objectively measured at 0, 4 months, and 1, 2, 3, and 4 years. RESULTS Participants who experienced more life events prior to study entry had lower session attendance (p < .01) and retention (p < .01), although no differences in weight outcomes were observed (p = .39). Baseline perceived stress followed a similar pattern. Participants who experienced more life events and higher perceived stress during the initial in-person program (0-4 months) appeared to experience less favorable weight outcomes long-term (p = .05 for life events, p = .04 for stress). Very few associations differed by treatment arm. CONCLUSIONS Experiencing more life events and stress was negatively associated with program engagement and may impair long-term weight outcomes for YAs. Future work should consider identifying YAs at highest risk and tailoring interventions to better meet their needs. (PsycInfo Database Record (c) 2023 APA, all rights reserved).
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Affiliation(s)
| | | | | | - Jacqueline F. Hayes
- Weight Control and Diabetes Research Center at the Miriam Hospital
- Alpert Medical School of Brown University
| | - Deborah F. Tate
- University of North Carolina at Chapel Hill
- UNC Lineberger Comprehensive Cancer Center
| | | | | | | | - Erica Robichaud
- Weight Control and Diabetes Research Center at the Miriam Hospital
| | | | - Rena R. Wing
- Weight Control and Diabetes Research Center at the Miriam Hospital
- Alpert Medical School of Brown University
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Browne J, Xie H, Wolfe RS, Naslund JA, Gorin AA, Aschbrenner KA. Factors associated with weight gain prevention in young adults with serious mental illness. Early Interv Psychiatry 2023; 17:39-46. [PMID: 35347848 DOI: 10.1111/eip.13289] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/03/2021] [Revised: 02/04/2022] [Accepted: 03/13/2022] [Indexed: 01/21/2023]
Abstract
AIM The purpose of this study was to examine factors associated with weight gain prevention among young adults with serious mental illness who participated in the Fit Forward randomized controlled trial evaluating lifestyle interventions adapted for this high-risk group. The aims were to: (1) examine baseline differences between participants that gained weight and those that lost or maintained weight at six and 12 months, and (2) evaluate whether changes in weight control strategies were associated with weight gain prevention at 6 and 12 months. METHODS This study was a secondary analysis of the Fit Forward Study. Participants were young adults (age 18-35) with a serious mental illness and a body mass index in the overweight or obese range. Participants completed assessments at baseline and 6 and 12 months. t-Tests and chi-squared tests were used to examine baseline differences between those that gained weight and those that lost/maintained weight. Logistic regression was used to evaluate whether changes in weight control strategies were associated with weight gain prevention in the sample overall. RESULTS Lower baseline BMI was significantly associated with weight gain prevention at six and 12 months. Greater increases in weight control strategies total score and psychological coping subscale were significantly associated with weight gain prevention at six and 12 months. CONCLUSIONS Weight control strategies, particularly psychological coping tools that support positive thinking and reduce negative self-talk should be considered as core strategies in healthy lifestyle interventions aimed at preventing weight gain in young adults with serious mental illness.
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Affiliation(s)
- Julia Browne
- Geriatric Research, Education and Clinical Center, Durham VA Health Care System, Durham, North Carolina, USA
| | - Haiyi Xie
- Biomedical Data Sciences, Geisel School of Medicine at Dartmouth, Lebanon, New Hampshire, USA
| | - Rosemarie S Wolfe
- Department of Psychiatry, Geisel School of Medicine at Dartmouth, Lebanon, New Hampshire, USA
| | - John A Naslund
- Department of Global Health and Social Medicine, Harvard Medical School, Boston, Massachusetts, USA
| | - Amy A Gorin
- Institute for Collaboration on Health, Intervention, and Policy, University of Connecticut, Storrs, Connecticut, USA
| | - Kelly A Aschbrenner
- Department of Psychiatry, Geisel School of Medicine at Dartmouth, Lebanon, New Hampshire, USA
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Sysko R, Bibeau J, Boyar A, Costello K, Michaelides A, Mitchell ES, Susanin A, Hildebrandt T. A 2.5-Year Weight Management Program Using Noom Health: Protocol for a Randomized Controlled Trial. JMIR Res Protoc 2022; 11:e37541. [PMID: 35969439 PMCID: PMC9419047 DOI: 10.2196/37541] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/24/2022] [Revised: 06/28/2022] [Accepted: 06/28/2022] [Indexed: 11/13/2022] Open
Abstract
BACKGROUND Overweight and obesity are serious public health concerns. As the prevalence of excess weight among individuals continues to increase, there is a parallel need for inexpensive, highly accessible, and evidence-based weight loss programs. OBJECTIVE This weight loss trial will aim to examine the efficacy of the Noom weight loss program in comparison to a digital control after a 6-month intervention phase and a 24-month maintenance phase, with assessments continuing for 2 years beyond the intervention (to 30 months-after the baseline). The secondary outcomes include quality of life, psychosocial functioning, sleep quality, physical activity, diet, and health status. This trial will also examine the severity of obesity-related functional impairment, weight loss history, and demographic moderators, along with adherence and self-efficacy as mediators of the outcome. METHODS A total of 600 participants were randomized in a parallel-group, controlled trial to either Noom Healthy Weight Program (intervention) or Noom Healthy Weight Control (control) for a 6-month intervention. Both intervention and control groups include diet and exercise recommendations, educational content, daily logging capabilities, and daily weigh-in entries. The Noom Healthy Weight Program also includes a coach support for weight loss. Remote follow-up assessments of eating, physical activity, psychosocial factors, app use data, and weight will be conducted at 1, 4, 6, 12, 18, 24, and 30 months after baseline. Weight is measured at each follow-up point during a Zoom call using the participants' scales. RESULTS Enrollment began in March 2021 and the 6-month intervention phase ended in March 2022. Data collection for the final assessment will be completed in March 2024. CONCLUSIONS This study tests commercially available digital lifestyle interventions for individuals with overweight and obesity seeking weight loss support. Data obtained from the study will evaluate whether the Noom Healthy Weight Control Program can help individuals overcome weight loss, achieve long-term maintenance, adhere to lifestyle changes, and feature use barriers that are present in other traditional weight loss treatments. TRIAL REGISTRATION ClinicalTrials.gov NCT04797169; https://clinicaltrials.gov/ct2/show/NCT04797169. INTERNATIONAL REGISTERED REPORT IDENTIFIER (IRRID) DERR1-10.2196/37541.
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Affiliation(s)
- Robyn Sysko
- Eating and Weight Disorders Program, Icahn School of Medicine at Mount Sinai, New York, NY, United States
| | - Jessica Bibeau
- Eating and Weight Disorders Program, Icahn School of Medicine at Mount Sinai, New York, NY, United States
| | - Allison Boyar
- Eating and Weight Disorders Program, Icahn School of Medicine at Mount Sinai, New York, NY, United States
| | - Kayla Costello
- Eating and Weight Disorders Program, Icahn School of Medicine at Mount Sinai, New York, NY, United States
| | | | | | - Annabel Susanin
- Eating and Weight Disorders Program, Icahn School of Medicine at Mount Sinai, New York, NY, United States
| | - Tom Hildebrandt
- Eating and Weight Disorders Program, Icahn School of Medicine at Mount Sinai, New York, NY, United States
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Hayes JF, Schumacher LM, Lanoye A, LaRose JG, Tate DF, Espeland MA, Gorin AA, Lewis CE, Jelalian E, Wing RR. Persistent, High Levels of Social Jetlag Predict Poor Weight Outcomes in a Weight Gain Prevention Study for Young adults. J Behav Med 2022; 45:794-803. [PMID: 35841487 DOI: 10.1007/s10865-022-00339-w] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/02/2021] [Accepted: 06/20/2022] [Indexed: 11/25/2022]
Abstract
INTRODUCTION Social jetlag (SJL), the discrepancy in sleep timing between weekdays and weekends, is associated with higher BMI and cardiometabolic risk and is common in young adults. We examined whether chronic SJL impacts weight gain in young adults participating in a weight gain prevention trial. METHODS Young adults (n = 599, age 18-35; BMI: 21.0-30.9 kg/m2) completed assessments at 0, 4, 12, and 24 months. Multilevel mixed growth models were used to examine (1) associations between demographics and longitudinal SJL and (2) longitudinal SJL as a predictor of weight change and cardiometabolic outcomes. SJL was assessed as a continuous and clinically-significant dichotomous (< vs. ≥2 h) variable. RESULTS 38% of participants had clinically-significant SJL at ≥ 1 timepoints (Baseline M ± SD = 1.3±0.89). Younger (b=-0.05, p < 0.001), female (b = 0.18, p = 0.037) and Black (compared to White, b = 0.23, p = 0.045) participants were more likely to have greater SJL. Individuals with high SJL (≥ 2 h; between-person effect) were more likely to have greater weight gain over 2 years (b = 0.05, p = 0.028). High SJL did not affect the rate of change in waist circumference or cardiometabolic markers over time. CONCLUSIONS High SJL is associated with greater weight gain over time. Reducing SJL may positively impact weight status in young adults.
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Affiliation(s)
- Jacqueline F Hayes
- Warren Alpert Medical School of Brown University, Providence, Rhode Island, USA. .,Weight Control and Diabetes Research Center, The Miriam Hospital, Providence, Rhode Island, USA.
| | - Leah M Schumacher
- Warren Alpert Medical School of Brown University, Providence, Rhode Island, USA.,Weight Control and Diabetes Research Center, The Miriam Hospital, Providence, Rhode Island, USA
| | - Autumn Lanoye
- Department of Health Behavior and Policy, Virginia Commonwealth University School of Medicine, Richmond, Virginia, USA.,Massey Cancer Center, Virginia Commonwealth University, Richmond, Virginia, USA
| | - Jessica Gokee LaRose
- Department of Health Behavior and Policy, Virginia Commonwealth University School of Medicine, Richmond, Virginia, USA
| | - Deborah F Tate
- Gillings School of Global Public Health, University of North Carolina-Chapel Hill, Chapel Hill, North Carolina, USA
| | - Mark A Espeland
- Department of Internal Medicine, Wake Forest School of Medicine, Winston-Salem, North Carolina, USA
| | - Amy A Gorin
- Department of Psychological Sciences, University of Connecticut, Storrs, Connecticut, USA
| | - Cora E Lewis
- Department of Epidemiology, University of Alabama at Birmingham, Birmingham, Alabama, USA
| | - Elissa Jelalian
- Warren Alpert Medical School of Brown University, Providence, Rhode Island, USA.,Weight Control and Diabetes Research Center, The Miriam Hospital, Providence, Rhode Island, USA
| | - Rena R Wing
- Warren Alpert Medical School of Brown University, Providence, Rhode Island, USA.,Weight Control and Diabetes Research Center, The Miriam Hospital, Providence, Rhode Island, USA
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Hayes JF, Tate DF, Espeland MA, LaRose JG, Gorin AA, Lewis CE, Jelalian E, Bahnson J, Wing RR. Patterns of weight change in a weight gain prevention study for young adults. Obesity (Silver Spring) 2021; 29:1848-1856. [PMID: 34549535 PMCID: PMC8570998 DOI: 10.1002/oby.23268] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/20/2021] [Revised: 07/20/2021] [Accepted: 07/23/2021] [Indexed: 11/10/2022]
Abstract
OBJECTIVE Recovery from weight regain is uncommon during weight loss treatment. This study examined whether participants in a weight gain prevention intervention similarly struggle to recover following weight gains and which factors predict transitions. METHODS This is a secondary analysis of data from the Study of Novel Approaches to Weight Gain Prevention (SNAP), a randomized controlled trial comparing two weight gain prevention interventions with a control group. Young adults (n = 599; age 18-35 years) were followed over 3 years. Markov models identified transition rates in going above and returning below baseline weight across follow-up. Logistic regressions identified predictors of transitions. RESULTS At each time point, approximately double the number of participants who transitioned from below to above baseline transitioned from above to below. The magnitude of weight changes from baseline and the number of weight loss strategies used predicted transitions from below to above and above to below baseline weight (with opposite relationships). Infrequent self-weighing and lower dietary restraint predicted transitions below to above baseline weight. Treatment arm, demographics, calorie consumption, and physical activity generally did not predict transitions. CONCLUSIONS Young adults engaging in weight gain prevention struggle to lose gained weight. Alternative strategies are needed to address weight gains in weight gain prevention interventions.
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Affiliation(s)
- Jacqueline F. Hayes
- Alpert Medical School of Brown University, Miriam Hospital, Providence, Rhode Island
| | - Deborah F. Tate
- Gillings School of Global Public Health, University of North Carolina-Chapel Hill, Chapel Hill
| | - Mark A. Espeland
- Department of Internal Medicine, Wake Forest School of Medicine, Winston-Salem, North Carolina
| | - Jessica Gokee LaRose
- Department of Health Behavior and Policy, Virginia Commonwealth University School of Medicine Richmond
| | - Amy A. Gorin
- Department of Psychological Sciences, University of Connecticut, Storrs
| | - Cora E. Lewis
- Department of Epidemiology, University of Alabama at Birmingham, Birmingham
| | - Elissa Jelalian
- Alpert Medical School of Brown University, Miriam Hospital, Providence, Rhode Island
| | - Judy Bahnson
- Gillings School of Global Public Health, University of North Carolina-Chapel Hill, Chapel Hill
| | - Rena R. Wing
- Alpert Medical School of Brown University, Miriam Hospital, Providence, Rhode Island
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Call CC, D'Adamo L, Butryn ML, Stice E. Examining weight suppression as a predictor and moderator of intervention outcomes in an eating disorder and obesity prevention trial: A replication and extension study. Behav Res Ther 2021; 141:103850. [PMID: 33839586 DOI: 10.1016/j.brat.2021.103850] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/11/2020] [Revised: 02/16/2021] [Accepted: 03/19/2021] [Indexed: 10/21/2022]
Abstract
Weight suppression (WS) predicts future weight gain and increases in eating disorder symptoms in community and clinical samples but has received minimal attention in obesity and eating disorder prevention programs. In a sample of emerging adults (N = 364) in a randomized controlled trial evaluating two obesity and eating disorder prevention interventions versus a control condition, this study aimed to replicate the findings that WS and its interaction with baseline BMI predict increases in weight and eating disorder symptoms and test a novel hypothesis that WS would moderate the effects of the interventions on change in weight and eating disorder symptoms. Participants completed assessments at baseline, post-intervention, 6-, 12-, and 24-months. WS was calculated as the difference between highest lifetime weight and baseline weight. WS interacted with baseline BMI to predict greater weight gain over 24-months, such that those with high WS and lower baseline BMI gained weight most rapidly. WS did not predict eating disorder symptom change and did not moderate the effects of the prevention programs. Given that individuals with WS are at increased risk for weight gain, expressly targeting this high-risk population with evidence-based obesity prevention programs may be useful. CLINICALTRIALS.GOV REGISTRATION: NCT01680224.
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Affiliation(s)
- Christine C Call
- Department of Psychology, Drexel University, Stratton Hall Suite 119, 3141 Chestnut St, Philadelphia, PA, 19104, USA; Center for Weight, Eating and Lifestyle Science, Drexel University, Stratton Hall Second Floor, 3201 Chestnut St, Philadelphia, PA, 19104, USA.
| | - Laura D'Adamo
- Department of Psychology, Drexel University, Stratton Hall Suite 119, 3141 Chestnut St, Philadelphia, PA, 19104, USA; Center for Weight, Eating and Lifestyle Science, Drexel University, Stratton Hall Second Floor, 3201 Chestnut St, Philadelphia, PA, 19104, USA.
| | - Meghan L Butryn
- Department of Psychology, Drexel University, Stratton Hall Suite 119, 3141 Chestnut St, Philadelphia, PA, 19104, USA; Center for Weight, Eating and Lifestyle Science, Drexel University, Stratton Hall Second Floor, 3201 Chestnut St, Philadelphia, PA, 19104, USA.
| | - Eric Stice
- Department of Psychiatry and Behavioral Sciences, Stanford University School of Medicine, 401 Quarry Road, Stanford, CA, 94305-5101, USA.
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